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CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameCALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN
Plan identification number 501

CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CALIFORNIA STATE ASSOCIATION OF COUNTIES has sponsored the creation of one or more 401k plans.

Company Name:CALIFORNIA STATE ASSOCIATION OF COUNTIES
Employer identification number (EIN):946000551
NAIC Classification:921000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-05-01KELSEY NOLAN2024-05-01
5012022-05-01KELSEY NOLAN2024-01-17
5012021-05-01
5012021-05-01KELSEY NOLAN
5012020-05-01
5012019-05-01
5012018-05-01
5012018-05-01
5012017-05-01TINA ARMSTRONG

Plan Statistics for CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN

401k plan membership statisitcs for CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN

Measure Date Value
2023: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-05-01114
Total number of active participants reported on line 7a of the Form 55002023-05-01111
Number of retired or separated participants receiving benefits2023-05-010
Number of other retired or separated participants entitled to future benefits2023-05-010
Total of all active and inactive participants2023-05-01111
Number of employers contributing to the scheme2023-05-010
2022: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01104
Total number of active participants reported on line 7a of the Form 55002022-05-01114
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01114
Number of employers contributing to the scheme2022-05-010
2021: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01105
Total number of active participants reported on line 7a of the Form 55002021-05-01104
Total of all active and inactive participants2021-05-01104
Total participants2021-05-01104
2020: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01108
Total number of active participants reported on line 7a of the Form 55002020-05-01106
Total of all active and inactive participants2020-05-01106
Total participants2020-05-01106
2019: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01106
Total number of active participants reported on line 7a of the Form 55002019-05-01108
Total of all active and inactive participants2019-05-01108
Total participants2019-05-01108
2018: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01110
Total number of active participants reported on line 7a of the Form 55002018-05-01106
Total of all active and inactive participants2018-05-01106
Total participants2018-05-01106
2017: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01100
Total number of active participants reported on line 7a of the Form 55002017-05-01110
Total of all active and inactive participants2017-05-01110
Total participants2017-05-01110

Form 5500 Responses for CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN

2023: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-05-01Type of plan entitySingle employer plan
2023-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-05-01Plan funding arrangement – InsuranceYes
2023-05-01Plan funding arrangement – General assets of the sponsorYes
2023-05-01Plan benefit arrangement – InsuranceYes
2023-05-01Plan benefit arrangement – General assets of the sponsorYes
2022: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – General assets of the sponsorYes
2019: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – General assets of the sponsorYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – General assets of the sponsorYes
2018: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – General assets of the sponsorYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – General assets of the sponsorYes
2017: CALIFORNIA STATE ASSOCIATION OF COUNTIES HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01First time form 5500 has been submittedYes
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – General assets of the sponsorYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number245595
Policy instance 3
Insurance contract or identification number245595
Number of Individuals Covered114
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $8,921
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $385,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 2
Insurance contract or identification number65740
Number of Individuals Covered199
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $46,031
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,486,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberK7237210
Policy instance 1
Insurance contract or identification numberK7237210
Number of Individuals Covered111
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $6,879
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $186,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberK7237210
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 2
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number245595
Policy instance 3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number390175
Policy instance 4
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number245595
Policy instance 4
NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberK7237210
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number390175
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number390175
Policy instance 3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number245595
Policy instance 4
NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberK72-37210
Policy instance 1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number390175
Policy instance 5
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051117
Policy instance 4
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberK72-37210
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 2
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number245595
Policy instance 1
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number245595
Policy instance 5
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number245595
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 2
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberK72-37210
Policy instance 3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number390175
Policy instance 4
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051117
Policy instance 5
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051117
Policy instance 1
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberK72-37210
Policy instance 2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number390175
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 4
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number390175
Policy instance 5
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051117
Policy instance 4
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberK72-37210
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number65740
Policy instance 2
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number245595
Policy instance 1

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